515例言语语言障碍患儿病因分析

Etiological Analysis of 515 Children with Speech and Language Disorders

周浩;熊才运;刘烨;杨媛媛;赵魏情;崔玉霞;骆文龙;

1:贵州省人民医院儿科

2:贵州省人民医院耳鼻咽喉头颈外科

3:重庆医科大学附属第二医院耳鼻咽喉头颈外科

摘要
目的了解言语语言障碍患儿的病因,为制定个体化干预措施提供临床依据。方法回顾性分析2017年4月至2018年10月期间因"不会说话、词汇量少、发音不清"就诊于贵州省人民医院发育行为专科门诊并确诊为言语语言障碍的515例患儿的临床资料,分析年龄、性别、发育水平测试、听力筛查、孤独症评估、S-S语言发育评估、构音障碍评估结果及可能的病因。结果 515例患儿中确诊为单纯语言发育迟缓280例(54.37%)、儿童孤独症105例(20.39%)、智力障碍71例(13.79%)、功能性构音障碍36例(6.99%)、听力障碍6例(1.17%)、其它17例(3.30%,包括口吃4例、失语症1例、脑性瘫痪12例)。不同病因患儿之间言语语言障碍的类型差异有统计学意义(P<0.05),男性言语语言障碍患儿的理解能力、表达能力、交流态度障碍比例高于女性(P<0.05)。结论本组言语语言障碍患儿最主要的原因是语言发育迟缓,其次为孤独症、智力障碍等,不同病因患儿言语语言障碍的评估结果存在差异,对言语语言障碍的患儿应尽早进行病因学诊断,便于制定有针对性的干预措施。
关键词
言语语言障碍;病因;S-S语言发育评估;儿童
基金项目(Foundation):
贵州省人民医院博士基金[GZSYBS(2016)07]
作者
周浩;熊才运;刘烨;杨媛媛;赵魏情;崔玉霞;骆文龙;
参考文献

1 Arora NK,Nair MKC,Gulati S,et al.Neurodevelopmental disorders in children aged 2-9 years:population-based burden estimates across five regions in India[J].PLoS Med,2018,15:e1002615.

2 Reilly S,Wake M,Bavin EL,et al.Predicting language at 2 years of age:a prospective community study[J].Pediatrics,2007,120:e1441.

3 葛海静,黄敏辉,詹建英.儿童语言发育迟缓就诊延迟相关因素分析[J].中国儿童保健杂志,2016,14:325.

4 梁茂萍,陆琼超,陈玉翠,等.儿童语言发育迟缓94例临床分析[J].广东医学院学报,2012,30:438.

5 Abbeduto L,Boudreau D.Theoretical influences on research on language development and intervention in individuals with mental retardation[J].Ment Retard Dev Disabil Res Rev,2004,10:184.

6 陈雷平,王周阳.早期干预措施对儿童语言发育迟缓的影响分析[J].中国妇幼卫生杂志,2018,9:28.

7 刘丽,姚蕊,王恬,等.幼儿语言发育迟缓干预治疗的临床研究[J].宁夏医学杂志,2017,39:930.

8 尹晓,李玉.早期认知语言康复训练对发育迟缓患儿的影响[J].中国听力语言康复科学杂志,2018,16:125.

9 于萍.儿童言语语言障碍[J].中国听力语言康复科学杂志,2016,4:303.

10 梁静,王朝晖.S-S语言发育迟缓评价法与Gesell发育评估量表在幼儿语言评定应用中的对比[J].中国儿童保健杂志,2017,25:514.

11 李欢.构音障碍评估研究述评[J].中国特殊教育,2010(6):59.

12 高铁英,赵婵娟,郝淑红.功能性构音障碍儿童智力结构分析[J].中国儿童保健杂志,2019,27:451.

13 Zhou H,Zhang L,Luo X,et al.Modifying the autism spectrum rating scale (6~18 years) to a Chinese context:an exploratory factor analysis[J].Neurosci Bull,2017,33:175.

14 Zhou H,Li C,Luo X,et al.Cross-cultural revision and psychometric properties of the Chinese version of the autism spectrum rating scale (2~5 years)[J].Front Neurol,2018,9:460.

15 任爽,麻宏伟,胡曼,等.孤独症筛查量表M-CHAT与CHAT-23的临床应用研究[J].中国当代儿科杂志,2012,14:946.

16 Mikolajewski AJ,Scheeringa MS,Weems CF.Evaluating diagnostic and statistical manual of mental disorders,fifth edition posttraumatic stress disorder diagnostic criteria in older children and adolescents[J].J Child Adolesc Psychopharmacol,2017,27:374.

17 刘烨,李家琼,熊才运,等.发育筛查量表的评价者间信度和共聚效度分析[J].中国当代医药,2018,25:4.

18 张海丛,许家成,方平,等.韦氏儿童智力测验与认知评估系统对轻度智力障碍儿童测试的比较分析[J].中国特殊教育,2010(2):19.

19 Thirumala PD,Carnovale G,Loke Y,et al.Brainstem auditory evoked potentials' diagnostic accuracy for hearing loss:systematic review and meta-analysis[J].J Neurol Surg B Skull Base,2017,78:43.

20 Schachinger-Lorentzon U,Kadesjo B,Gillberg C,et al.Children screening positive for language delay at 2.5 years:language disorder and developmental profiles[J].Neuropsychiatr Dis Treat,2018,14:3267.

21 张瑞芳,周凤娟,章依文.语言发育迟缓儿童的发育水平剖析[J].临床儿科杂志,2010,28:718.

22 Hill TL,Gray SA,Kamps JL,et al.Age and adaptive functioning in children and adolescents with ASD:the effects of intellectual functioning and ASD symptom severity[J].J Autism Dev Disord,2015,45:4074.

23 Randall M,Egberts KJ,Samtani A,et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children[J].Cochrane Database Syst Rev,2018,7:D9044.

24 Li G,Liu M,Sun Q,et al.Early diagnosis of autism disease by multi-channel CNNs[J].Mach Learn Med Imaging,2018,11046:303.

25 邹冰.儿童孤独症与特定性言语和语言发育障碍的鉴别诊断[J].中国儿童保健杂志,2012,20:867.

26 Eissa N,Al-Houqani M,Sadeq A,et al.Current enlightenment about etiology and pharmacological treatment of autism spectrum disorder[J].Front Neurosci,2018,12:304.

27 华丽,郝燕,陈敏,等.儿童语言发育迟缓发育特征及危险因素分析[J].中国儿童保健杂志,2018,26:1140.

28 Mcclure EB.A meta-analytic review of sex differences in facial expression processing and their development in infants,children,and adolescents[J].Psychol Bull,2000,126:424.